<![CDATA[Background: Pharmacies, as pharmaceutical service facilities, are expected to provide quality services amid increasing operational complexity and public expectations. Challenges like dispensing errors, non-compliance with service standards, and inefficiencies in inventory management can affect patient safety and operational sustainability. Therefore, data-based performance measurement tools are needed to support continuous quality improvement. Objective: This narrative review is prepared to examine the basic concepts of KPIs in pharmaceutical services, identify relevant indicators along with factors that influence their implementation, and formulate a framework for applying KPI based on the Balanced Scorecard in pharmacies. Method: The research uses a narrative review method with a descriptive-qualitative approach. Literature was obtained from Google Scholar, PubMed, and ScienceDirect using keywords related to KPI, pharmacy management, Balanced Scorecard, and pharmaceutical services. Articles that met the inclusion criteria were analyzed to identify KPI indicators, supporting and inhibiting factors, and implementation strategies. Results: The study results indicate that pharmacy KPIs can be classified into four main domains: operational, clinical, financial, and patient satisfaction. KPI implementation is influenced by supporting factors such as managerial leadership, human resource readiness, the availability of integrated information systems, and the suitability of indicators to the local context. Conversely, major obstacles include staff's lack of understanding of the KPI concept, limitations in digital recording systems, and the lack of standard KPIs for community pharmacies. The implementation of the Balanced Scorecard framework is considered relevant for integrating various perspectives of pharmacy performance in a comprehensive and measurable manner. Conclusion: KPIs are an effective tool for objectively measuring and improving pharmacy performance. Implementing Balanced Scorecard-based KPIs has the potential to improve the quality of pharmaceutical services and support the sustainability of pharmacy operations.]]>
